{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T02:15:45Z","timestamp":1792462545492,"version":"4.5.0"},"reference-count":82,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T00:00:00Z","timestamp":1738627200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005711","name":"Universit\u00e4t Hamburg","doi-asserted-by":"publisher","award":["Not applicable."],"award-info":[{"award-number":["Not applicable."]}],"id":[{"id":"10.13039\/501100005711","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Over 630 million women and children worldwide have been displaced by conflict or live dangerously close to conflict zones. While the adverse effects of physical destruction on healthcare delivery are relatively well understood, the effects on healthcare-seeking behavior remain underexplored, particularly in sub-Saharan Africa. This study aims to better understand the interconnections and knowledge gaps between exposure to armed violent conflicts and healthcare-seeking behaviors for maternal and child health in sub-Saharan Africa.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Five key electronic databases (PubMed, Scopus, Web of Science, PsycNET, and African Journals Online) were\n                      <jats:bold>s<\/jats:bold>\n                      earched for peer-reviewed publications between 2000 and 2022. The review was designed according to PRISMA-P statement and the protocol was registered with PROSPERO database. The methodological quality and risks of bias were appraised using GRADE. A data extraction instrument was modelled along the Cochrane Handbook for Systematic Reviews and the Centre for Reviews and Dissemination of Systematic Reviews.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>The search results yielded 1,148 publications. Only twenty-one studies met the eligibility criteria, reporting healthcare-seeking behaviors for maternal and child health. Of the twenty-one studies, seventeen (81.0%) reported maternal health behaviors such as antenatal care, skilled birth attendance, postnatal care services, and family planning. Nine studies (42.8%) observed behaviors for child health such as vaccination uptake, case management for pneumonia, diarrhea, malnutrition, and cough. While conflict exposure is generally associated with less favorable healthcare-seeking behaviors, some of the studies found improved health outcomes. Marital status, male partner attitudes, education, income and poverty levels were associated with healthcare-seeking behavior.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>There is a need for multifaceted interventions to mitigate the impact of armed violent conflict on healthcare-seeking behavior, given its overall negative effects on child and maternal healthcare utilization. While armed violent conflict disproportionately affects children\u2019s health compared to maternal health, it is noteworthy that exposure to such conflicts may inadvertently also lead to positive outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec005\">\n                    <jats:title>Prospero registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.crd.york.ac.uk\/prospero\/display_record.php?ID=CRD42023484004\" xlink:type=\"simple\">CRD42023484004<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0317094","type":"journal-article","created":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T13:33:58Z","timestamp":1738676038000},"page":"e0317094","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":27,"title":["Armed violent conflict and healthcare-seeking behavior for maternal and child health in sub-Saharan Africa: A systematic review"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5398-0183","authenticated-orcid":true,"given":"Gbadebo Collins","family":"Adeyanju","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pia","family":"Schrage","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6828-4228","authenticated-orcid":true,"given":"Rabiu Ibrahim","family":"Jalo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liliana","family":"Abreu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2057-7002","authenticated-orcid":true,"given":"Max","family":"Schaub","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,2,4]]},"reference":[{"issue":"4","key":"pone.0317094.ref001","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1080\/13623699.2021.1971824","article-title":"The social determinants of health and health seeking behaviour in populations affected by armed conflict: a qualitative systematic review","volume":"37","author":"E Munezero","year":"2021","journal-title":"Med Confl Surviv"},{"issue":"6","key":"pone.0317094.ref002","doi-asserted-by":"crossref","first-page":"e843","DOI":"10.1016\/S2214-109X(23)00152-3","article-title":"Examining the relationship between armed conflict and coverage of maternal and child health services in 35 countries in sub-Saharan Africa: a geospatial analysis","volume":"11","author":"F Amberg","year":"2013","journal-title":"Lancet Glob Health"},{"issue":"10150","key":"pone.0317094.ref003","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1016\/S0140-6736(18)31437-5","article-title":"Armed conflict and child mortality in Africa: A geospatial analysis","volume":"392","author":"Z. 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